Delivery of macrosomia in a Cameroonian referral facility: epidemiological, clinical, therapeutic and prognostic aspects

Abstract

Introduction: Macrosomia represents a high-risk obstetrical situation because it is at the origin of an important maternal-fetal morbidity through its numerous complications, reason for which it would put at risk the maternal-fetal vital prognosis. However, few studies have been carried out in our environment, hence the need to contextualize and update the data. Objective: Our objective was to study the epidemiological, clinical and therapeutic aspects of the delivery of macrosomia at the Gynaecological-Obstetric and Paediatric Hospital of Yaoundé. Methodology: This was a descriptive cross-sectional study with prospective data collection at the Gynaecological-Obstetric and Paediatric Hospital in Yaoundé. The recruitment period was spread over 4 months, from 03 January to 07 May 2021. Thus, we included in our study, women who delivered a macrosomic newborn and gave their informed consent for the study. The data collected were analyzed using SPSS version 22.0 software. Results: In total, we included 52 participants. We obtained a frequency of 6.23% of macrosomal deliveries at the HGOPY. The most represented age group was between 25 and 30 years for an average age of 29 years.Diabetes was found in a small proportion (1.9%), Obesity was found in 12% of cases. Induction of labour was necessary in 13% of cases. Uterine heights between 34 and 37 cm were predominant in 56% of cases. Multiparous women were the most common in 32% of cases, and postterm in 7% of cases. The most common presentation was cephalic at 92%. Caesarean section was necessary in 37% of cases and occurred mostly in emergency at 85% and the use of oxytocin was the majority. Complications at delivery were dominated by perineal lesions in 70% of cases and delivery haemorrhage in 60% of cases. We observed 92% of macrosomic newborns with a weight between 4000 and 4499 grams. Male sex was predominant in 72%. Fetal complications occurred in 11% of cases and were dominated by hypoglycemia and fetal death in utero. We did not record any neonatal or maternal deaths. Conclusion: Macrosomia is common in our study site. It mainly concerns women from the western region, with an average age of 30 years. The rate of caesarean section is high allowing the birth of a boy in the majority of cases. Maternal complications are dominated by perineal lesions and delivery haemorrhage, fetal complications by in utero fetal death and hypoglycaemia. Perinatal mortality is high.